Provider Demographics
NPI:1437587060
Name:DEER, CARRIE C (PMH-NP)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:C
Last Name:DEER
Suffix:
Gender:F
Credentials:PMH-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 N JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75766-3801
Mailing Address - Country:US
Mailing Address - Phone:903-586-5507
Mailing Address - Fax:903-586-4234
Practice Address - Street 1:5656 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:TX
Practice Address - Zip Code:75766-9641
Practice Address - Country:US
Practice Address - Phone:903-589-9000
Practice Address - Fax:903-586-9200
Is Sole Proprietor?:No
Enumeration Date:2013-10-16
Last Update Date:2018-11-13
Deactivation Date:2018-10-29
Deactivation Code:
Reactivation Date:2018-11-13
Provider Licenses
StateLicense IDTaxonomies
SC18534363LP0808X
TXAP126784363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health